The 130th Annual Meeting of APHA

Abstract #46454

Lauren K. Gooden, MPH¹, Lisa R. Metsch, PhD¹, and Lee Crandall, PhD². (1) Department of Epidemiology and Public Health, University of Miami School of Medicine, 1801 NW 9th Ave., 3rd floor (D-93), Miami, FL 33136, 305-243-3487, lgooden@med.miami.edu, (2) Department of Epidemiology and Public Health, University of Miami, P.O Box 016069, Miami, FL 33101

Background: Physicians serving HIV-positive patients are in prime positions to decrease transmission of HIV by providing transmission risk reduction counseling (TRRC) to newly diagnosed and established HIV-positive patients. We conducted a mail survey of 50 physicians providing care to HIV-positive patients in three South Florida Counties to identify the factors that influence their decisions in providing TRRC to HIV+ patients. Methods: Physicians were asked to describe their counseling practices with newly diagnosed and established HIV+ patients. Logistic regression was used to identify factors associated with providing high levels (91% or more patients) of TRRC. Results: Physicians were more likely to provide TRRC to newly diagnosed than to established HIV+ patients (66% vs. 28%). Providing a high level of TRRC to established HIV-positive patients was associated with physician awareness that the clinic has a TRRC policy (OR 5.709; 95% CI 1.132 – 28.786) and spending an average of >30 minutes with established patients (OR 6.704; 95% CI 1.229 – 36.567). Providing a high level of TRRC to newly diagnosed patients was associated with female providers (OR 6.564; 95% CI, 1.440 – 29.914) and perceiving that over half of colleagues at the health care facility were providing HIV prevention counseling to their HIV-positive patients (OR 5.861; 95% CI, 1.152 – 29.833). Conclusions: Physicians are providing low levels of TRRC to their newly diagnosed HIV-positive patients and, especially to their established HIV-positive patients. Interventions and policy implementation are needed to develop, evaluate and enforce strategies to improve the delivery of HIV prevention within the HIV care setting.

Learning Objectives: At the conclusion of the session, the participants will be able to

• List two factors associated with physicians’ providing HIV transmission risk reduction counseling to newly diagnosed HIV+ patients.
• List two factors associated with physicians’ providing HIV transmission risk reduction counseling to established HIV+ patients.

Keywords: HIV/AIDS, Counseling

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.